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SECOND APPEAL 



TO THE 



PEOPLE OF PENNSYLVANIA 



ON THE SUBJECT OF 



AN ASYLUM FOR THE INSANE POOR. 









"0 



f 



SECOND APPEAL 



7 






TO THE 



PEOPLE OF PENNSYLVANIA 

/ 



ON THE SUBJECT OP 



AN ASYLUM FOR THE INSANE POOR 



OP 



THE COMMONWEALTH. 



F u.s. a.. 

^ PHILADELPHIA 
PRINTED FOR THE COMMITTEE. 

BROWN, BICKING & GUILBERT, PRINTERS, NO. 56 NORTH THIRD STREET, 

1840. 



COMMITTEE. 




THOMAS P. COPE, Chairman. 



FREDERICK A. PACKARD, Secretary. 



JOSEPH R. INGERSOLL, 
ROBLEY DUNGLISON, M. D., 
JOHN M. READ, 
REV. DR. TYNG, 
SAMUEL R. WOOD, 
JOHN K. KANE, 
SAMUEL B. MORRIS, 
ISAAC COLLINS, 
EDWARD YARNALL, 
REV. DR. DEMME, 
THOMAS EARP, 
.BENJAMIN H. COATES, M. D., 
THOMAS BRADFORD, 
JUDGE KING, 

GEO. WASHINGTON SMITH, 
BENJAMIN W. RICHARDS, 
DANIEL KEIM, 



JOB R. TYSON, 
CHARLES EVANS, M. D., 
WM. S. HANSELL, 
TOWNSEND SHARPLESS, 
CASPAR MORRIS, M. D., 
JESSE R. BURDEN, M. D., 
AMBROSE WHITE, 
I. N. MARSELLIS, M. D., 
JOHN GOODMAN, 
J. J. SMITH, JR., 
REV. DR. MAYER, 
JOHN FARNUM, 
GEORGE N. BAKER, 
JUDGE TODD, 
GEORGE B. WOOD, M. D., 
ROBT. M. PATTERSON, M. D„ 
THOMAS STEWARDSON, M. D. 



SECOND APPEAL. 



It is nearly two years since a meeting of Citizens was held in the 
city of Philadelphia, to take into consideration the propriety of adopt- 
ing measures to establish, at public expense, an asylum for the Insane 
Poor of Pennsylvania. At this meeting, it was resolved on motion of 
Joseph R. Ingersoll, Esq. — " that it is expedient to make application to 
the Legislature for the passage of an act to authorize the purchase of 
extensive grounds and the construction of a State Asylum for the re- 
relief of the Insane Poor of the State of Pennsylvania;" and farther, 
" that a Committee be appointed to prepare, print and circulate memo- 
rials to the Senate and House of Representatives, and cause them to 
be presented — to procure and publish information (statistical and other- 
wise) on this interesting subject, and to adopt such other measures as 
may in their opinion contribute to the success of the undertaking." 

With the view of enabling the public to clearly comprehend the 
necessity for such an Institution, as the one proposed, an Appeal on the 
subject was published to the People of Pennsylvania ; and subsequently 
memorials were sent to the Senate and House of Representatives, be- 
fore whom a Bill was introduced, accompanied by a report from Mr. 
Konigmacher, the Chairman of the Committee to whom the subject 
had been referred. 

This Bill passed the House of Representatives with but slight 
opposition, and the Senate unanimously, but on account of the ex- 
hausted condition of the Treasury, it did not receive the sanction of 
the Executive. After stating this objection to the Bill, the Governor 
proceeds; — "No friend of this measure can deplore more deeply than 
I do the stern injunctions of duty by which I am governed. The 
object for which the Bill provides is one that appeals directly to all the 
best feelings and charities of the human heart. It makes that appeal 
under the solemn sanctions of official duty, social obligation and 



4 

Christian Philanthropy.. I feel its force. I acknowledge its justice ; 
and gladly — most gladly — would I yield to its most virtuous sympa- 
thies;" and he adds his belief " that at no very distant day the Com- 
monwealth will be so far extricated from her present embarrassments 
as to be able, without inconvenience, to accomplish the laudable un- 
dertaking, which is now unavoidably postponed." 

Participating in the benevolent sentiments expressed by Governor 
Porter; impressed with the irreparable evils which must result from 
delay, and believing, that the period had arrived for farther action, 
and that certain objections which were made against the former Bill 
could be entirely obviated, the Committee of Citizens, at a meeting held 
on the 25th of September last, appointed a Sub-Committee, consisting 
of Robley Dunglison, M. D., Isaac Collins, and the Rev. C. R. Dem- 
me, D. D., to prepare a second appeal to the people of Pennsylvania, 
which should embrace such portions of the former Appeal, and of the 
Report made to the Legislature, and such other information as the 
Sub-Committee might think proper. 

At a meeting of the Committee, held on the 9th of October, 1840, 
the Sub-Committee, through their Chairman — Dr. Dunglison — reported 
the following Appeal, which was approved; ordered to be printed, to be 
signed by the Chairman and Secretary of the Committee, and to be 
published under the direction of the Sub-Committee in such form as to 
secure its most extensive circulation. 

In the absence of accurate statistical information in 
regard to Pennsylvania, an attempt was made, in the 
former Appeal, to deduce the number of insane persons 
in that commonwealth from the ratio that was found to 
exist in a neighbouring state. These estimates led to 
the belief, that the number of Lunatics in Pennsylvania 
might be 600 or 700, and of Idiots 1000 or 1100, and 
this was at the time regarded as a low estimate. 
Subsequent examination led to the belief, that it was 
much below the real amount. In the able Report in 
relation to an asylum for the insane poor, read in the 
House of Representatives, by Mr. Konigmacher, on 
the 11th of March, 1839, the Committee to whom the 



subject had been referred, reported, that they had re- 
ceived information from nearly half the counties of the 
State, from which it appeared, that there was an ag- 
gregate of upwards of eleven hundred insane persons — 
including idiots — in a population not exceeding 800,000. 
This ratio, which is 1 in about 728, closely approximates 
that deduced from the enumeration of the state of 
New York in 1825, which has been recorded amongst 
the Statistics of Insanity by Esquirol and other writers 
on the subject, and which shewed, that the ratio in that 
State was 1 in about 721. It is gratifying, however, to 
find, that subsequent statistical information has shewn, 
that as the population of New York has increased, the 
proportion of the insane has not increased in a corres- 
ponding ratio, but, on the contrary, has diminished. In 
the year 1835, a fresh enumeration was made, when the 
proportion of lunatics was found to be 1 in 2249 nearly ; 
of idiots 1 in 1465 and a fraction, and of both classes 
1 in 887 and a fraction ; — a diminution in ten years in 
the ratio of 887 to 721. 

Although it is certainly justifiable to take the neigh- 
bouring, extensive, and populous State of New York, 
which contains nearly one sixth part of the population of 
the Union, as the basis of our estimates in respect to 
this State, the result can only be regarded as an ap- 
proximation, and were we not possessed of information 
respecting the number of the insane in most of the 
counties of the State, it might not even be entitled to 
this consideration. Singular and inexplicable difficul- 
ties exist when we reflect on the results of statistical 
inquiries on this subject in many countries. A distin- 
guished writer on insanity — M. Brierre de Boismont — 
who has published a work within the last year on the 



6 

influence of civilization on the development of insanity ; 
and who considers the disease to prevail, as a general 
rule, in a direct ratio with the state of civilization of the 
people, — estimates the proportion of insane in different 
countries as follows : — State of New York, 1 in 721 ; 
England, 1 in 783 ; Scotland, 1 in 563 ; Norway, 1 in 
551 ; France, 1 in 1000 ; Districts on the Rhine, 1 in 
1000; Belgium, 1 in 1014; Holland, 1 in 1046; Italy, 
1 in 4879; and Spain, 1 in 7181. 

The proportion in the large cities he enumerates as 
follows :— London, 1 in 200; Paris, 1 in 222; Milan, 
1 in 242 ; Florence, 1 in 338 ; Turin, 1 in 344 ; Dresden, 
1 in 466; Rome, 1 in 481 ; Naples, 1 in 791 ; St Peters- 
burg, 1 in 3133 ; Madrid, 1 in 3350; and Grand Cairo, 
1 in 30714. 

Singular and inexplicable differences exist in the pro- 
portion of the insane to the whole population in many- 
of the States of this Union. In New Hampshire, when 
the population did not exceed 280,000, the number of 
lunatics was estimated at 600; in Connecticut, in a 
population of 298,000, at 700 ; in Massachusetts, with 
a population of about 612,000, there were 1,000; and 
in Virginia, taking the population at 1,200,000, it was 
considered that there were, in 1838, not fewer than from 
600 to 800 insane persons. 

It is not an object of this Appeal to inquire into the 
causes of these differences, if they really exist. They 
are adduced for the purpose of exhibiting the difficulties 
in the way of arriving at more than an approximation, 
and that in assuming the proportion in New York, ac- 
cording to the enumeration of the State, in 1835, a ratio 
is adopted much less than that which is considered to 
prevail in most other countries, and in States not far 
distant from Pennsylvania. 



Under the very lowest estimate, it is probable, that 
there are, at this time, in Pennsylvania, 2000 insane, of 
whom — if we take again the State of New York as a 
guide — the proportion of idiots will be about 1200 and 
of lunatics 800. Of these 2000 insane, all are not in a 
condition to require the aid of such a charity as is con- 
templated. Some are able to remain at home, others 
are in the valuable institutions established for the re- 
ception of these unfortunates in the vicinity of this city 
and elsewhere ; whilst others, again, are in an entire 
state of destitution, and are receiving their support in 
the county almshouses, are subsisting under some form 
of charity, or are immured in the various prisons of 
the commonwealth. These last alone concern us in 
the present inquiry. 

Wherever statistical inquiries have been made into 
the proportion of the insane amongst the indigent 
classes, the results have been the source of great sur- 
prise. Of 14,000 insane persons in England and Wales, 
it has been supposed on competent authority — Sir An- 
drew Halliday — that 11,000 are indigent. The results of 
inquiries made in the neighbouring States would shew, 
that this estimate cannot be wide of the mark as re- 
gards Pennsylvania. We are certainly, we think, justi- 
fied in considering that nearly two-thirds of the whole 
number or 1,200 are destitute; and hence, that 500 
Lunatics at least — exclusive of Idiots — might require 
the assistance, which the contemplated asylum will be 
capable of affording. 

The indigent poor of this commonwealth may be di- 
vided into three classes : the first including those who 
are kept at home under the charge of their friends : 
the second those who are in the almshouses or are 



8 ' 

farmed out ; and the third those who are in the prisons 
and penitentiaries. 

The first class embraces chiefly idiots, and such as 
are insane, but harmless. It is not common, — as was 
remarked by the commissioners of one county of the 
commonwealth, in answer to official inquiries, — for those 
who can support themselves by any means to be sent to 
poor houses, until they become unmanageable at home; 
and even under the last circumstances they are fre- 
quently kept at home, in conditions which render all at- 
tempts at recovery unavoidable. A report from one of 
the counties mentions an insane man, who had been sup- 
ported by a poor mother for 12 years constantly chained. 

It is now admitted, every where, that the chances of 
restoration are slight indeed, where the individual is 
kept constantly amongst the scenes and objects that 
gave rise to, or are connected with his delusion : but 
when, in addition to this, he is subjected to ill treatment 
and to every form of privation, it is scarcely necessary 
to add, that recovery must be next to impossible. A 
well regulated hospital affords the only means of re- 
storation, and where restoration is impracticable, of ren- 
dering the condition of the insane as comfortable as 
their melancholy infliction permits. No private estab- 
lishment can possess adequate means for bestowing 
regular and appropriate attendance, and hence it fre- 
quently happens that with the most affectionate feeling 
on the part of relatives, the ordinary attendants neglect 
their duty, and at times with results that are most ca- 
lamitous. In the former Appeal, allusion was made to 
the fatal consequences of inevitable neglect, during the 
cold of a winter, of unusual severity, in a case which 
was attempted to be treated at home, under the unfor- 



9 

tunate impression, on the part of the respectable family, 
that the ordinary servants of the house would be able 
to attend to the sufferer, and that there was something 
revolting in sending a relative to a public institution, 
where neglect was possible, and where he would be de- 
prived of those tender cares, which relatives — it was 
erroneously conceived — are alone able to bestow. 

It is to be lamented, that these feelings still prevail to 
too great an extent amongst both the rich and the poor; 
yet they are gradually fading before the lights of ex 
perience, and soon — it is to be hoped, for the good of 
humanity — will vanish altogether. One of the earliest 
evidences of insanity is generally a dislike to those to 
whom the insane have been previously most attached, 
and whose sympathy or control they indignantly reject. 
These feelings continue as long as the aberration; and 
hence the importance of removing them, at an early 
period, from these perverted associations to institutions 
in which they are taught from their first admission to 
brook control, and in which — at the same time — every 
attention is paid to dispel the morbid hallucination, and 
to minister to their happiness. 

Compare the reports of some of our best institutions 
with the statements we are doomed to hear of physical 
suffering, where the insane are deprived of the neces- 
sary cares. " During the residence of nearly six years," 
says the Sixth Annual Report of the Superintendent 
of the State Lunatic Hospital, Worcester, Massa- 
chusetts, " we have been exempt from severe sickness, 
and no epidemic has ever visited the Hospital. In this 
period, we have had under our care eight hundred 
and fifty-five patients, exhibiting insanity in all its 
forms, from the high excitement which induces its vic- 

2 



10 

tim to discard and destroy his raiment, and expose 
himself to injuries, in a manner wholly reckless of con- 
sequences, to that state of imbecility and torpor, which 
unfits him from attending to what is absolutely neces- 
sary to his existence, much more to his security and 
comfort; yet we have never, in a single instance, had a 
patient either burned, scalded or frozen" 

It would be but correct to infer, that the second class 
of insane paupers, who are in the county alms- 
houses, are in a better condition than those who are 
supported at home on public or private bounty. Such 
is unquestionably the fact in our best almshouses — of 
which the Philadelphia almshouse at Blockley is an ex- 
cellent specimen ; yet from the very mixed nature of 
the establishment it is impossible to have those means 
and appliances, which are indispensable to the proper- 
treatment of the insane. It is requisite, that the build- 
ing accommodations should have been erected for the 
express purpose, in order that due classification may be 
adopted ; and that ample facilities should exist for em- 
ployment in labour, or amusement, that may exercise 
the mind, and abstract it from its delusion. Except, in- 
deed, at an early period of the disease, physical 
management is generally of but little avail. Admitting, 
that insanity may be essentially physical in its nature, 
it is not an affection, which, after it has continued for 
some time, is capable of being generally cured by re- 
medies, that are employed for the removal of ordinary 
corporeal excitement ; and hence the main stay of the 
physician is in the adaptation of a proper moral manage- 
ment, for which the best of our county almshouses, 
affords us but imperfect facilities ; and the rest few, if 



11 

nny. It is indeed deplorable to peruse the statements 
made on authority, and contained in the Report to the 
Legislature of Pennsylvania, to which reference has 
already been made. 

"We have two places only" — says one of the county 
reports — "for the reception of the insane poor, — the 
common poor house and the county jail. In the latter 
place are generally males, who are too violent and dan- 
gerous to be kept in a common poor house. For the 
public peace and protection of the community, they 
were charged with breaches of the peace, or petty 
misdemeanors that were made the pretence for con- 
finement, and being unable to give bonds were com- 
mitted. Here their society is chiefly convicts, or if 
kept in solitary confinement, so ill are the accommoda- 
tions for this, that they suffer more than the rigour of 
penitentiary discipline, and thus are they kept from 
year to year, with the same treatment that is meted 
out to those convicted of high crimes. In one instance, 
a man, who had been a minister of the gospel, being 
without the means of removal, or support in a private 
asylum, was sent to the poor house : here he became 
violent, and dangerous and escaped. It was considered 
necessary for the protection of his family and the pub- 
lic from injury, that he should be committed to the 
public jail, where he remained a year or more, without 
any accommodation or comfort other than what is af- 
forded to the common felon. He is now at a private 
hospital at an expense of $ 3 per week to the county. 

"A maniac is now in our gaol under sentence of 
death for a most atrocious murder. There was no in- 
dication of insanity at the trial, nor when he was sen- 
tenced, but, a few weeks after, there was strong evi- 
dence of mental alienation, and his execution has been 



12 

postponed under reprieves, upon the representations of 
physicians and others. He is-alone in his department, 
fettered and chained, and has been in this situation 
about nine months, deprived of all comfort, &c." 

A report from another county thus describes its 
accomodations for those unfortunates. 

" The accommodations for the insane in the county 
poor house consist of a single room, in which the furious 
and violent are confined, — male and female in the same 
apartment, separated only by the length and restraint 
of their chains. Their hands being at liberty, they 
frequently strip themselves of all covering. The con- 
dition of these furious and violent maniacs, confined in 
the same room, destitute of all comforts, and with every 
thing around calculated to aggravate their madness, is 
degrading and deplorable in the extreme. Bad as is 
the condition of poor insane lunatics, dwelling in pri- 
vate hovels of poverty, the condition of the violent is 
better there, with more comfort and hope of alleviation 
and relief, than in the mad apartment of the public 
poor house, chained with others as mad as themselves : 
although they may not have as regular an allowance 
of bread and meat in the humble cabin, yet there they 
may have eyes to pity, hands to afford relief, or voices 
to utter some comfort and consolation." 

" The county poor house is under the control of a 
steward, who has a large farm, and perhaps a hundred 
paupers to employ, manage and provide for, from day 
to day. Changes in the office of steward are often 
occurring. The attending physicians are elected also 
at intervals of one or two years ; their pay, if any, is 
very inconsiderable, and however strong may be their 
desire to alleviate the suffering of the insane, there 
are no facilities for the employment of suitable means," 



13 

Another report states: — "We have no special ac- 
commodation for the insane, and such as we have is 
wretched. They are kept in an old dilapidated build- 
ing scarcely tenantable. Five or six are chained in so 
many small separate compartments on the same floor. 
In a word, the insane of this county, whether in or out 
of the poor house, are, we are sorry to say, scarcely 
considered proper objects of medical attention and 
still less of moral discipline." 

In another county, a memorial was addressed to the 
Board of Guardians of the poor, by the attending phy- 
sicians, which set forth, that they have, for a long 
time, regretted the defectiveness of the present ar- 
rangement for the treatment of insane patients " The 
only apartments now used," they remark, " are in a 
damp, confined, ill- ventilated and comfortless situation; 
calculated more to increase both the physical and men- 
tal derangement of such patients, than to co-operate 
with the sanative influence of medical treatment:" 
and they add ;— " that we are not disposed to exag- 
gerate the deficiencies and inconveniences of the pre- 
sent arrangement, it is only necessary to state, that 
since the erection of the present building, several 
lives have been lost, from the imperfect construction 
of the cells for the insane ; and where no possible blame 
could attach to the keepers." 

This memorial was made part of the report of the 
grand jury to the court of quarter sessions, in August, 
1838. At the November sessions following, the pre 
siding judge called the particular attention of the grand 
jury to the hospital, and they were induced to visit the 
premises, accompanied by the attending physician. 
After a full and fair examination of their condition, the 



14 

grand jury say: — " these unfortunate individuals (the in- 
sane) are now placed in confined, damp, and illy ven- 
tilated apartments on the ground floor, resembling more 
the cells of a prison, than any thing else. When per- 
mitted to take exercise and recreation in the open air, 
they are loaded like convicts with hobbles, and chains, 
and exposed in summer to the hot sun without the pro- 
tection of a single shady tree. — In this situation, they 
associate in the same yard with the other paupers, who, 
though more rational, unfeelingly provoke them with 
jeers and scoffs, and thus aggravate the violence of their 
disease. Under these circumstances, the grand jury 
believe it impossible to render them such medical and 
moral assistance, as their peculiar diseases require, and 
which are curable only, by a proper combination of 
physical, medical and moral treatment. Distressing, 
as it is to the feelings of humanity, it is notwithstanding 
true, that this class of patients, which call loudest for 
our sympathy and our aid, and whose disease, we are 
informed, requires the nicest and most exact kind of 
treatment, are here placed in a situation wholly unfit 
for the successful treatment of any disease, and parti- 
culary for that of insanity. These unfortunate beings 
are deprived of even the ordinary comforts of the 
pauper, and their derangement instead of being cured, 
becomes confirmed." 

"From two to four physicians are annually elected 
to attend all the inmates of the hospital. The year is 
then divided into sections, and each physician attends 
singly his own section. During this period, the physi- 
cian seldom visits the insane regularly, and seldom 
prescribes for them. This is owing to the imperfect 
and uncomfortable arrangements made for them, and 



15 

the impossibility of combining proper, moral and physi- 
cal treatment with the medical. In consequence, 
therefore, of the imperfect construction of the build- 
ing, the medical treatment of the insane at our hos- 
pital, is more neglected than that of any class of 
individuals in the house." 

In one county — it is stated in the report — of forty 
persons more or less deranged, seven are confined in 
cells, which are nearly, if not quite, under ground, who 
may be seen from without through iron bars in the cel- 
lar windows : amongst them — it is said — is a German 
girl, 20 years of age, seemingly in perfect bodily health, 
with beautiful teeth and hair, and without exhibiting 
any evidences of malignity, who had been in a similar 
cell for five months, and was deemed incurable. This 
case — it was presumed — by proper treatment in an in- 
sane hospital, might have been susceptible of com- 
plete restoration. 

These are but a part of the painful details presented 
to the Legislature, but they are sufficient to establish 
the necessity of better provision for this afflicted por- 
tion of our fellow citizens. It is but just to add, that 
equal mismanagement and wretchedness exist else- 
where ; for, strange to say, it is but as yesterday, that 
the lunatic and the idiot have been esteemed worthy 
of the attentions of the humane, and capable of being 
extensively benefited by either physical or moral 
management. Institutions, it is true, were erected to 
receive them, but they were provided rather with the 
view of safety to the community than of restoration 
to society. Even so late as the year 1835, and in the 
country of Pinel, — which has been distinguished for 
early and successful efforts for the improvement of the 



16 

condition of the insane, — it appears from the report of 
M. Ferrus, which rests on official documents, transmit- 
ted to the ministers by the prefects of police, that 
chains were still in use in some of the country Asylums : 
that at Mereville, in the department of the Vosges, the 
cages, in which furious maniacs are confined, are in 
cellars not raised more than a foot above the ground. 
These cages are made of wood, and are partly closed 
only, — the remainder being open so as to exhibit the 
interior: their dimensions four feet wide, and six deep; 
and the light admitted only from corridors and cellars. 
Through the bars of these cages, in some of the 
towns, the miserable occupants receive their straw and 
food. 

Even at this day, we are told by Mr. Packard, — in a 
pamphlet just published, and entitled " Memorandum 
of a late visit to some of the principal Hospitals, Pri- 
sons, &c, in France, Scotland and England, embraced 
in a letter to the acting committee of the Philadelphia 
Society for alleviating the miseries of public prisons — 
in La Salpetriere — the extensive Institution of the 
Metropolis of France, which contained, at the time 
of his visit, 5,500 inmates, of whom 1,200 were lunatics, 
500 epileptics, and 300 idiots — the spectacle in the 
wards and yards was more horrible than his fancy 
could have depicted. In one of the inclosures, he saw 
15 or 20 small buildings, resembling very closely those 
which are put up in Zoological gardens for particular 
classes of wild animals ; the doors double like those of 
a prison. In some of these buildings, a place was fit- 
ted up greatly resembling the cages of lions and tigers 
in menageries. The floor was strewed with straw, and 
a thick strong barrier, similar to the rack from which 



17 

cattle are accustomed to be fed, separated the maniac 
from the spectator. 

Nor does the country of Howard form an exception 
in respect to these abuses. Gross and revolting was 
the former management of her insane institutions; but 
publicity — properly considered as the best remedy for 
such abuses — has mainly rectified the evil; yet, as has 
been recently remarked by Dr. Conolly,* the accom- 
plished superintendent of the Hanwell Asylum, there 
is scarcely an institution in the kingdom of Great Bri- 
tain from which the shadow of former evils is altogether 
departed. " Scarcely credible does it now seem, that 
no longer back than twenty years ago, the condition of 
lunatic houses throughout France, and with some ex- 
ceptions throughout Europe, should have been such as 
we find it described in M. Esquirol's historical review 
of those establishments. Prisons and dungeons were 
built and dug for them, and chains forged for them. 
To prevent their dying of sheer hunger was the sum 
of duty apparently thought due to them, and they were 
every where the victims of ignorance, of prejudice and 
of terror. The patients (in France) were found by him 
covered with rags, lying upon straw, miserably fed, and 
grossly abused by ignorant and brutal keepers. Air to 
breathe and water to drink were almost equally ex- 
cluded from them ; they were chained like wild beasts, 
but in dens into which wild beasts would not have been 
put." Dr. Conoliy adds; — "M. Esquirol's Atlas of Plates, 
will perpetuate the remembrance of a method of en- 
chaining a poor officer of the Navy in Bethlem, even 18 
years after Pinel had struck the chains from off the 

* We take it for granted, that the able article in the British and 
Foreign Medical Review, for January 1840, is from his pen. 

3 



18 

limbs of the lunatics in the Bicetre. The poor man, 
when convalescent, is said to have threatened one of 
the physicians, and as ordinary means of restraint 
were evaded by the patient, an ingenious apparatus of 
iron was brought from Newgate and applied to him. 
This unhappy person is the subject of the last plate, 
and is represented sitting on a bed of wood and straw, 
his arms bound, his legs manacled, and a collar round 
his neck, by which he was fastened, by a chain ten 
inches long, to an upright iron pillar behind him. The 
weight of the apparatus was twenty-three pounds, and 
the patient (it ought rather to be said the prisoner) was 
unable to walk about or to stand upright, or even to 
lie down : and in this state he was permitted to remain 
nine years!" 

Reverting, then, to the condition of the second class, 
according to the division we have made of our insane 
paupers, it is obvious, that as regards those who are 
kept in the alms houses, their condition is frequently 
wretched in the extreme, and in no instance as favour- 
able to recovery as it would be in an establishment in- 
stituted for the purpose. Nor can we say more in 
favour of the system of farming out the insane. " Our 
poor," says one of the county reports, " are bound out 
at so much a year to those who will take them at the 
cheapest rate : from this you may infer, how far their 
situation is comfortable or how far their unfortunate 
condition is likely to be ameliorated." 

The third class of Insane are those who are con- 
fined in prisons and penitentiaries for safe keeping, 
a practice, which has been adopted in many countries, 
and to a certain extent over the whole of this and other 
States. The refractory lunatic is committed to the 



19 

common jails or penitentiaries, where he may be 
safely kept from injuring others, but where, of course, 
he can receive neither appropriate physical nor moral 
treatment. When, again, a prisoner, who has commit- 
ted a crime, is declared by the verdict of a Jury to be in- 
sane, — in the absence of an asylum, like the one proposed, 
he is doomed by the Court to the cell of the convict, to 
pass there the remainder of his existence — provided his 
delusion continues so long ; punished in the same man- 
ner as if he had been declared guilty of the crime, whilst 
in the eye of the law he is innocent ; and immured for 
a mental infliction, which might often, assuredly, be re- 
moved under judicious management in a proper asylum. 
What expectations of restoration could be indulged in 
the case of one so circumstanced, and what stronger 
incentive could be offered to the benevolent, for the es- 
tablishment of an institution, which could afford se- 
curity to the public against farther violence, whilst, at 
the same time, it permitted the employment of the 
means best adapted for the recovery of the wretched 
offender ! Yet, in the absence of a proper asylum, the 
course adopted by our tribunals is inevitable, and it is 
the source of painful solicitude to every merciful and 
enlightened judge. " The want of such an asylum" — 
say the judges of the Court of Quarter Sessions;* 
and of the Criminal Courtt of Philadelphia — a senti- 
ment, which is fully concurred in by the judge of the 
12th Judicial district J — " often occasions painful embar- 
rassment to the courts, when the defence, in a criminal 
charge, is insanity, fully sustained in proof: although the 
Jury may certify, that their acquittal is on that ground, 

* Judges King, Randall and Jones. f Judges Todd, Bouvier and 
Conrad. % Judge Blythe. 



20 

and thus empower the court to order the prisoner into 
safe custody, yet that custody can be in no other place 
than the common prisons, places illy qualified for such 
a subject of incarceration : we cannot doubt, that the 
ends of justice would be greatly promoted if such an 
asylum, as the petitioners contemplate, were established 
under proper regulations, and the courts were author- 
ized to commit to it persons acquitted of crimes upon 
the plea of insanity." 

It would appear, that five-sixths of the inmates of 
the State Lunatic Asylum of Massachusetts were com- 
mitted by order of the courts, — having been convicted 
of outrages upon the person or property of others, or 
the court esteeming it to be dangerous to the peace 
and safety of the commonwealth to suffer them to be 
at large. 

Thus far, we have considered only the evils that re- 
sult from the present condition of the indigent insane 
of this commonwealth. A brighter picture has now to 
be presented,™— of the advantages, that must accrue from 
adopting a course like that which it is the object of 
this Appeal to inculcate. 

In the early periods of history, when but little, if any, 
sound philosophy prevailed, and the human mind was 
enshrouded in darkness and prejudice, insanity was 
regarded as a direct infliction from the Almighty, which 
it was believed to be idle to attempt to remove ; it has 
been, however, a triumph to the science and philan- 
thropy of modern times to exhibit, that it is one of 
the most curable of maladies, when treated early ; 
and one of the most inveterate, when it has per- 
sisted for any considerable period; and yet, that in 



21 

these last cases, much can be done to alleviate the con- 
dition of the sufferers. 

In the former Appeal, evidence was afforded to shew, 
that the ratio of curability of cases, which had existed 
less than three months, was 9 in 10; and 8| in 10, 
when it had existed under twelve months ; that on the 
other hand of 318 cases, which had fallen under the care 
of Sir William Ellis, at the York West Riding Asylum, 
and which had existed from 1 to 30 years, only 26 were 
cured ; and that M. Esquirol, one of the greatest liv- 
ing authorities on the subject of insanity, had asserted? 
that after the disease had passed the third year of du- 
ration, the probability of cure was scarcely more than 1 
in 30. Such, too, have been the general inferences 
deduced from the results in several of the admirable 
insane establishments of our own country. 

There were admitted into the State Lunatic Asylum 
at Worcester, Mass., during the year 1839, four hun- 
dred and eighteen cases, of duration less than one year ; 
of these there were discharged, recovered, three hun- 
dred and forty cases, which is eighty -one and one- 
third per cent. The deaths of recent cases being de- 
ducted, the per centage will be eighty-four and three- 
fourths; "and if," — says Dr. Woodward, — "the recent 
cases now in the Hospital, which are convalescing or 
have been recently admitted, all of which have had in- 
sufficient trial, are deducted, the per cent, will be 
ninety-two and two-thirds. Of all the patients that 
have been in the Hospital, the recoveries have been 
forty-one per cent." 

How important, then, on all accounts, that the Com- 
monwealth should possess an institution into which the 
maniac can be transferred on the first appearance of the 



22 

hallucination, with every prospect of being soon restored 
to his position in society ; and of being but for a short 
period a burthen to the public ! In the absence of such 
an asylum, time is permitted to pass away ; until the in- 
sanity becomes so far developed, that danger is appre- 
hended from the lunatic being suffered to remain 
longer at large, when he is transferred to situations, 
which have been already indicated, and where the 
malady, which might have been readily arrested at the 
outset, has had time to produce morbid changes, 
which may set all art at defiance, and render the assis- 
tance of the commonwealth necessary throughout the 
remainder of existence. 

Although, however, the proportion of cures di- 
minishes so greatly as the disease is more protracted, 
many instances are on record, in which persons, who 
have been pronounced incurable, have been entirely 
restored. One memorable case is given by Pinel, of 
a lady, who had been maniacal for twenty-five years, 
suddenly recovering her reason. 

But what an improvement has taken place in the 
moral management of those unfortunates, at all periods 
of their disorder ! Forty-eight years ago, lunatics were 
in chains over the whole of Europe. It was in the 
year 1792, during the atrocities of the French Revo- 
lution, and under circumstances detailed at length in 
the former Appeal, that Pinel — the physician and the 
philanthropist; justly styled the 'great reformer' — ven- 
tured, in a few days, to strike the shackles from fifty-three 
lunatics ; and what a revolution followed from a course 
before esteemed impracticable, or, if practicable, of dis- 
astrous tendency ! The furious madmen, who de- 
stroyed hundreds of wooden utensils in the Bicetre, re- 



23 

nounced their habits of violence. Others, who tore 
their clothes, and rioted in filth and nudity, became 
clean and decent ; tranquillity and harmony succeeded 
to tumult and disorder, and many who had previously 
been deemed incurable, were restored to reason. 
" France," says Esquirol, " was the first nation to offer 
the spectacle of nearly three thousand lunatics kept in 
confinement without chains, without blows and without 
unkind treatment." 

But although the use of chains, and the lash, which 
was at one time freely applied, has been generally 
abandoned, it is but recently that a system of total 
abolition of personal restraint, in the treatment of the 
insane, has been openly inculcated and affirmed to be 
entirely effective. In the Lincoln Asylum, under the 
superintendence of Dr. Charlesworth, for twenty years 
past, and latterly with the vigilant co-operation of Mr. 
Hill, who has recently published a lecture, " with statis- 
tical tables illustrative of the complete practicability 
of the system advocated in the lecture," almost every 
kind of bodily restraint is stated to have fallen into dis- 
use, as superfluous or worse than superfluous, — and as 
a mere substitute for the want of watchful care. This 
great change, has only been effected, it is said, by a 
most careful adoption of a rigid system of constant 
superintendence, of well preserved classification, and 
of humane and effective practical management. 

" We are perfectly aware"— says a writer already 
quoted-— Dr. Conolly, in whose establishment at Han- 
well, the system of non-restraint is fully embraced ; 
and where according to Mr. Packard, the coercion 
chairs have been worked into the floor of the carpen- 
ter's shop—" that Mr. Hill's statements will be received 



24 

in many lunatic asylums, with surprise, and even with 
incredulity. The proportion of sane keepers to the 
patients is so very small in most of those Institutions, 
and so much habitual assistance is calculated upon 
from imperfectly recovered minds, that the effect to 
be expected from a better system of watchfulness has 
scarcely yet suggested itself to the imaginations of the 
directors and superintendents. Perhaps, indeed, it is 
difficult for any one, not familiar with the working of 
such a watchful system, to believe it sufficient in every 
case, without the old physical restraints. If the Lin- 
coln Asylum can present a model of this kind, which 
all may visit and examine, the services of Dr. Charles- 
worth to the cause of humanity, and in behalf of the 
insane, already considerable, will only be second to that 
of him who first released them from their chains." 

Mr. Hill goes so far as to affirm, " that in a properly 
constructed building, with a sufficient number of suita- 
ble attendants, restraint is never necessary, never justi- 
fiable, and always injurious, in all cases of lunacy 
whatever." 

Such, according to Mr. Packard, appear, also, to 
be the principles and the practice of Dr. Pritchard 
in the Lunatic Asylum at Northampton, England. 
"The non-restraining principle," says Mr. Packard, 
" is applied here in its ultra form. In one instance, 
the day I was there, the bed and bed clothes of 
a patient were completely changed four times be- 
tween 8 and 12 o'clock, a warm bath prepared each 
time, and the patient washed and her clothes changed 
throughout, rather than use severe measures for cor- 
recting or counteracting her propensities. In violent 
cases, the patient is placed alone, in a room well aired 



25 



and lighted, where there is nothing destructible, and 
treated with all the kindness which he is capable of 



receiving." 



Admitting the practicability and the efficiency of the 
system of non-restraint, in the large mass of cases, it 
may be well questionable, whether it be of universal 
application ; and were it so, it can rarely happen, that 
establishments for the insane are so well provided with 
competent attendants that corporeal restraint can be 
wholly dispensed with. The experience, however, of 
the large institutions of this country has sufficiently 
shewn, that it can be but seldom necessary. In the 
last annual report of the State Lunatic Asylum, at 
Worcester, the Managers affirm, that chains have 
never been thought of, and that the strait waistcoat or 
jacket has never been used ; and the same remark, as 
to the strait waistcoat, is made by the Directors of the 
Ohio Lunatic Asylum in the first annual report for 
the last year. "If the patient," they observe, "is re- 
ceived in a furious state, he is placed in a lodge appro- 
priated to such cases, or if one is seized with a 
paroxysm of mania in the wards, he is immediately 
removed until the paroxysm subsides, and then re- 
turned to his former situation." " Such," they add, " is 
the effect of the system of treatment adopted here, 
that in the halls, where from 18 to 20 are admitted to- 
gether during the day, no noise or violence exists, and 
with those, who a few weeks or days since were be- 
yond ordinary control, order, peace and decency of 
manner and language now prevail." 

In the Bloomingdale Asylum, too, it is affirmed, " it is 
long since there has been such a thing as a strait jacket 
in the establishment." 

4 



26 

From a multitude of cases at home and abroad, we 
may take one, which signally illustrates the character 
of the treatment of the insane many years ago, and 
the benefit, which has resulted from one far different 
in its character. " Within a month," says Dr. Wood- 
ward, " after the opening of the institution, there was 
placed under our care a man who had committed 
homicide. On his trial for that offence, he had been 
proved insane, and, for want of a more suitable place, 
was confined in the common jail of the county, in 
which the offence was committed. Here he had been 
imprisoned seventeen years, sometimes being permitted 
to have the company of the worst prisoners with whom 
he often quarreled, and by whom he was often sadly 
beaten and abused : sometimes, he was a long time in 
solitude, and occasionally loaded with heavy irons : at 
all times, he was in close confinement, and considered 
a dangerous man even when under the severest re- 
straints. 

When he first came into the Hospital, he was vio- 
lent, noisy, and often furious : he was permitted to enjoy 
the privilege of walking in the hall unrestrained, on 
condition that he would not injure his associates : he 
soon became more calm and pleasant, and was occa- 
sionally taken out to labour; he conducted himself 
well, and was soon indulged with greater liberties :^- 
the Bible was given him, and he was fond of reading it; 
he worked much abroad, and with great pleasure, as- 
sisted the women in the kitchen to scrub the floors and 
in their other labours. He has been thus indulged more 
than five years : he has injured no one abroad, and has 
been respectful and civil. He now takes his meals at 
table quietly and orderly ; attends chapel much of the 



27 

time, and although a very insane man, and at times 
violent in his langauge, is contented, peaceable, and 
happy, and when calm has no desire to leave the hos- 
pital, but considers it his residence for life." 

Twenty years ago, who would have credited the 
statement of Dr. Woodward, that of the one thousand 
and thirty-four patients, who up to December last 
have been in the Worcester Lunatic Hospital, there 
have not been twenty, who have not taken their food 
at the table with others, more or less of the time. Of 
these twenty, more than three-fourths were so ill and 
feeble when they arrived at the Hospital as to be un- 
able to do so, and died without amendment in a few 
days : and he affirms, that at the time of writing his 
report, they have not a solitary individual, who has not 
for a very considerable time taken food with others, 
with knives and forks. "The difference," says Dr. 
Woodward, " between eating food in solitude from a 
tin or wooden dish with the fingers or a spoon, and 
going to a neatly furnished table, and taking meals 
from crockery with a knife and fork, is the difference 
between a savage and a civilized man, a brute and 
a human being. No one thing contributes more to 
awaken self respect and restrain the furiously insane, 
than this indulgence at table, and the confidence, which 
he feels is placed in him by those who have him in 
keeping. The same is true in respect to dress and the 
treatment he receives from those whom he looks upon 
as superiors and whom he feels bound to obey. If he 
is neatly and comfortably clad, like those whom he 
meets, he feels that he is as good as others, respects 
himself as they appear to respect him, and is careful 
to do nothing by which he shall lose caste- If his gar- 



28 

ments are tattered or dirty, he will tear them off, or 
soil them more ; if neat and tidy, he will preserve them 
with care, and even feel proud of them." 

"Within a few days," he continues, "a patient was 
brought to the hospital, who had been confined three 
years in a cage : he had not used knife or fork to take 
his meals during this period, and had not felt the influ- 
ence of a fire for two winters. The gentleman, who 
brought him to our care manifested praiseworthy be- 
nevolence in his efforts to ameliorate his condition, and 
get him into more comfortable winter quarters, and 
hoped, that in a few months we should be able to im- 
prove his state, and that he would observe the decen- 
cies of life and take his food in a proper manner. While 
he remained conversing respecting him, the patient 
below was quietly seated at the table taking his supper 
with knife and fork in his hand ! On the second Sab- 
bath from his admission, he attended chapel quietly, 
and gave it as his unqualified opinion, that he was 
* well off.'" 

By this sustained treatment of mercy and kindness, 
it is found, that there are few, who are incapable of 
participating in appropriate labour or amusement. 
Every well devised lunatic asylum is so regulated, as 
to be able to employ such of the patients as are fitted 
for them, and to whom they are fitting, in agricultural 
or horticultural labours: workshops are provided { and 
employment or amusement of some kind or other is 
carefully adapted to each individual. 

The attention, which such occupations demand, pro- 
duces a strong moral revulsion, and prevents the 
recurrence of the insane ideas ; or, if they recur, pre- 
vents them from wholly engrossing the mind of the lu- 



29 

natic. This is now so well understood, that in the dif- 
ferent insane establishments of this country it is an 
object of anxious solicitude with the medical super- 
intendents, and the results have been most salutary. 

Who, again, a few short years ago, would have cred- 
ited the fact, that in a large insane asylum, four-fifths 
of the patients, who were in the institution during the 
past year, should have been brought to attend the ex- 
ercises of the chapel on the Sabbath, and most of them 
very regularly, and that numbers should have conduct- 
ed themselves in the chapels of the institutions with 
the greatest decorum, who in the halls were noisy, 
talkative and profane. Along with other circumstances 
the fact exhibits, that, however perverted may be the 
mental powers, there are but few, who are unsuscep- 
tible of appropriate appeals when judiciously em- 
ployed :— few who become, — 

" a wreck at random driven, 



Without one glimpse of reason or of Heaven." 

With such knowledge derived from experience can 
we be surprised, that under the active and benevolent 
exertions of philanthropists, extensive pauper lunatic 
asylums should have been erected both in Europe, and 
in several of the States of this Union. Without refer- 
ring particularly to the efforts in other countries, it 
may be well to glance at those of our own. 

Massachusetts, besides the establishment at Charles- 
town, capable of accommodating 200 patients, has her 
admirable state institution at Worcester, which is capa- 
ble of accommodating 230 persons and had at the close 
of the year, 218 patients. In addition to this, Boston 
has her own asylum for poor lunatics, situate at South 



30 

Boston, and capable of accommodating 100 patients, 
which was commenced in 1837, and was ready for the 
reception of patients in August, 1839. This Hospital — 
it appears from the report of the Superintendent, Dr. 
John S. Butler — was opened on the 11th of December, 
1839, and had at the time of the report, July 1, 1840, 
87 insane lunatics. It was erected principally by the 
prisoners in the House of Correction, is plainly but 
substantially built, and is said to be convenient and 
comfortable, and to answer well its intended purposes. 
Maine has her asylum on the banks of the Kennebeck, 
in sight of the State House at Augusta, which is in- 
tended to accommodate 100 poor patients. In New 
Hampshire, an association has been organized, a bill 
has passed the legislature, to establish an asylum for poor 
lunatics, and a committee has been appointed to choose 
its location. In Vermont an asylum has existed since 
1836; the average number of patients at which has 
been 35. In Connecticut, Governor Ellsworth, in May, 
1839, invited the attention of the assembly to the con- 
dition of the insane poor, and a committee of the 
Legislature reported in favour of endowing an appro- 
priate asylum. 

New York has most liberally entered into the career 
of benevolent sympathy. She has now three public 
asylums, — the Bloomingdale, seven miles from the city 
of New York, liberally endowed by the State and not 
confined in its benefits to the insane poor, — for the ac- 
commodation of about 150 insane patients ; the State 
asylum, exclusively for the insane poor, now building 
at Utica, for the accommodation of 1000 patients ; and 
the asylum on Blackwell's Island, only one wing of 
which is completed, for the accommodation, in this one 



31 

wing, of 200 patients. New Jersey is likewise im- 
pressed with the importance of such an institution, 
and active measures have been taken by the Legisla- 
ture to procure it. Virginia has her two lunatic hos- 
pitals, — the one situate at Williamsburg in Eastern 
Virginia ; the other at Staunton, on the western side of 
the Blue Ridge. The latter, according to the second 
annual report of its superintendent — Dr. Stribling, 
received, during the year 1838, 85 patients. Both in- 
stitutions have been liberally endowed by the State, and 
are capable together of receiving 250 patients. Mary- 
land — during the past year — has appropriated bounte- 
ously for the benefit of her insane poor. South Carolina 
has made large additions to her State asylum at Co- 
lumbia. Tennessee erected an asylum, not long ago, 
at Nashville. Kentucky has hers, into which 176 
patients were received during the year 1838; and the 
new asylum of Ohio, at Columbus, according to the 
annual report of the Directors for 1839, is in full and 
successful operation, — 157 patients having been re- 
ceived into it since its opening, of whom 114 remain. 

Would that we could add to this list of her Sister 
States — who have emulated each other in this career 
of benevolence and usefulness — Pennsylvania, extensive 
in her population and territory ; ample in her resources; 
ennobled by her charitable institutions of all kinds ; — 
her hospitals and alms houses ; her provision for the 
widow and the fatherless, the destitute and the peni- 
tent, — the afflicted, indeed, of every class, — save and 
except this, — the most wretched and pitiable of all ; and 
distinguished for her ready adoption of every proposi- 
tion, that can promote the happiness, and ameliorate 
the condition of her citizens ! She has contributed, it 



32 

is true, towards the erection of the Pennsylvania Hos- 
pital ; but this institution, even now, when a separate 
asylum for its insane has been established on the west- 
ern side of the Schuylkill, cannot, it is presumed, re- 
ceive more than 40 insane paupers. 

Were it necessary to appeal to other feelings than 
those of humanity, it might be readily shown, that in 
a pecuniary point of view advantage must inevitably 
accrue to the State from the contemplated establish- 
ment ; and that there are but few insane, who may not 
be profitably employed in useful, and in productive la- 
bour. The seventh annual report of the Trustees of the 
lunatic hospital at Worcester estimates the produce of 
the farm from the industry of the patients at 1914 dol- 
lars, without including the stock at the time in the yard. 
The market price of the work in the shoe shop, in the 
preceding 18 months, is valued at about 1822 dol- 
lars, — and these are but two of the channels — it must 
be borne in mind — into which the productive industry 
has been directed. 

In the present condition of the insane poor of this 
commonwealth, they have to be supported by the com- 
munity at even a higher expense than would he needed 
in a proper establishment ; no facilities are afforded 
for appropriate labour, and their support must be 
wholly derived from the district in which relief is ex- 
tended to them. So satisfied, indeed are the poor law 7 
Commissioners of England, of the economy of such 
establishments, that they are every where erecting 
their asylums for the insane paupers separate and dis- 
tinct from the poor houses. But this point, which, by 
a few, has not been accurately appreciated, and has 
been urged as an objection to the contemplated asylum 



33 

in Pennsylvania, has been set at rest numerically in 
one of the States of this Union. We quote from the 
sixth annual report by the Trustees of the same excel- 
lent Institution referred to above. 

" In order to present this subject strictly as a pecu- 
niary or economical matter, the Trustees requested the 
Superintendent to prepare a separate table, shewing 
the actual expense of twenty of the earliest cases re- 
ceived into the Hospital, which, owing to the duration 
of the disease when admitted, were incurable, and 
therefore still remain; and doubtless will continue a 
charge upon the State as long as life lasts. These 
cases are not selected, but are taken in their order. 
They are the first twenty cases of admission, which 
now remain. Their expense, before admission, is com- 
puted at one dollar and fifty cents a week. These 
cases have already cost the commonwealth one 
thousand five hundred and fifty dollars and fifty 
cents each. On the other hand, and as a contrast to 
the above? the table shews the actual expense of the 
last 20 cases, which have been discharged from the 
Hospital cured. It amounts only to forty-seven and 
a half dollars each. Hence it appears, that the ex- 
pense already incurred for taking care of twenty cases, 
which, from neglect, had been suffered to run on until 
they became incurable, has been more than thirty-two 
times greater than the expense of the same number of 
cases, for which early and proper provision was made. 
The recent cases are now well ; the old ones will doubt- 
less continue a charge through life. However extraor- 
dinary it may appear, it is still true, that taking an 
average chance for cures, it would have been a pecuni- 
ary saving to the State to have seasonable care of these 

5 



34 

old cases, though at an expense of eighty dollars a 
week, rather than, by neglect, to have incurred the 
necessity of supporting them, even up to the present 
time." 

Bearing these estimates in mind ; and ; in addition, the 
now well ascertained fact, that 90 per cent, of the re- 
cent cases can be restored so as to be able to maintain 
themselves and family; and that, in the opposite case the 
disease may be rendered perpetual, so that both the un- 
fortunate sufferer himself, and all those that are depen- 
dent upon him for support, may remain a burthen to the 
public, and it must be manifest, that the pecuniary sav- 
ing of such an asylum would be immense ; and that, con- 
sequently, it ought to receive zealous support not merely 
on the score of philanthropy but of economy. 

Such being the facts in regard to the condition of the 
insane poor in this commonwealth, — to adopt the main 
conclusions of our former appeal,— can farther argu- 
ments be needed to depict the necessity of an establish- 
ment of the kind, that is contemplated ? Shall we be con- 
tent with inaction, whilst our brethren every where are 
sedulously employed in their endeavours to restore to 
mental existence those who are afflicted with the most 
awful of dispensations ? Can we remain satisfied with 
their condition at home in their own miserable hovels, 
or with immuring them in institutions, where but imper- 
fect attempts at restoration are practicable, and where 
they are merely kept from inflicting injury upon them- 
selves or others, with the moral certainty, that in a large 
majority of the cases, hallucinations, which, under other 
arrangements, might have been wholly removed, must 
become more and more firmly implanted in the mind. 



35 

until ultimately the wretched maniac sinks prematurely 
under his excitement, or subsides into a state of hope- 
less melancholy or fatuity ? Or can we hesitate to exert 
all our energies to diminish evils of heart-rending 
extent, and to adopt measures, that may be within our 
reach, for restoring the unfortunate lunatic to his friends 
and to his country ; or of ameliorating his hard lot 
where perfect recovery is impracticable ? 

The evil that results from one single year's delay is 
inappreciable. We know, however, that it must be 
great, and that even a brief postponement removes the 
chances of restoration from hundreds, whose reason is, 
as it were, in our keeping. 

THOMAS P. COPE, Chairman. 
Frederick A. Packard, Secretary. 



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